WO2002055002A1

WO2002055002A1 - Motorised operating table with multiple sections

Info

Publication number: WO2002055002A1
Application number: PCT/FR2002/000051
Authority: WO
Inventors: Philippe Rocher; Jean-Marie L'hegarat
Original assignee: Fhsurgical
Priority date: 2001-01-09
Filing date: 2002-01-08
Publication date: 2002-07-18
Also published as: DE60228405D1; EP1349528A1; JP2004538037A; CA2434397A1; FR2819173B1; ATE405245T1; EP1349528B1; FR2819173A1; US20060080777A1; US7089612B2

Abstract

The invention concerns an operating table (10) comprising at least three elements (12, 14, 16, 30, 32, 34, 36) mobile relative to one another, and at least two actuators controlling each the displacement of two elements relative to each other, the table further comprising means for monitoring each actuator and means for detecting any risk of collision of one mobile element of the operating table with an obstacle when a first actuator executes a displacement request. It comprises means for determining a corrective instruction controlling a second actuator different from the first actuator, when detecting a risk of collision, the execution of the corrective control instruction by the second actuator stopping the detected risk of collision, when the first actuator executes a subsequent displacement request, and means for providing the user with said corrective control instruction.

Description

Motorized operating table with multiple sections.

The present invention relates to an operating table, of the type comprising at least three elements movable relative to each other, and at least two actuators each controlling the movement of two elements relative to each other, the table comprising further means for controlling each actuator and means for detecting a risk of collision of a movable element of the operating table with an obstacle during the execution of a request to move a first actuator .

In modern surgical operating tables, each movable element is controlled by a motorized actuator, in particular an electric one, allowing the surgeon or an operator to effortlessly move the controlled element.

Due to the multiplication of the movable elements with respect to each other and therefore the multiplication of the possible configurations of the table, numerous risks of collision of the elements with one another can arise. Likewise, the end elements can strike obstacles present in the operating room, and in particular the ground.

When such a collision occurs, or immediately before it, the movement of the operating table controlled by the user is interrupted. The stopping of the maneuver is often perceived by the user as a malfunction of the operating table. In addition, such a stop is difficult to interpret by the user who finds himself helpless when faced with a travel request which he wishes to execute and which he cannot implement for mechanical reasons which he does not always perceive. .

After an involuntary stop of a maneuver, the user often acts blindly on the other commands made available to him, without however being able to carry out the maneuver he wished to carry out initially later.

The object of the invention is to propose an operating table making it possible to avoid the embarrassment of the user when a collision occurs or is likely to occur between an element of the table and an obstacle present in the vicinity and in particular the ground, or when two moving elements of the table risk colliding. To this end, the subject of the invention is an operating table, of the aforementioned type, characterized in that it includes means for determining a corrective order for controlling a second actuator different from the first actuator, when the detection of a risk of collision, the execution of the corrective command order by the second actuator making the detected risk of collision cease, during a subsequent execution of the request to move the first actuator, and means of provision of this corrective order to the user.

According to particular embodiments, the table includes one or more of the characteristics defined in claims 2 to 8.

The invention will be better understood on reading the description which follows, given solely by way of example and made with reference to the drawings, in which:

- Figure 1 is a perspective view of an operating table according to the invention;

- Figure 2 is a schematic view of the actuating means of the table;

- Figure 3 is an elevational view of a table control member; - Figure 4 is a partial perspective view on an enlarged scale of the translational guide device of the table top;

- Figure 5 is a flowchart explaining an operating routine of the table; and

- Figures 6A, 6B, 6C, 6D, 6E, 6F and 6G are schematic elevational views of the table illustrating cases of collision of the movable elements of the table between them or of a movable element of the table with the ground .

The operating table 10 shown in FIG. 1 comprises a base 12, a pillar or column 14 and a plate 16 for supporting the patient. The tray consists of a set of elements hinged relative to each other to deform the surface on which the patient rests. Each of the movable elements of the table is associated with at least one actuator and a sensor, such as a potentiometer, making it possible to determine the position of the actuator, and thus to deduce therefrom the current position of the controlled element relative to the element relative to which it is movable.

For each movable element, the associated actuator is designated by the same reference number as the element, followed by the letter A, and the sensor is designated by the same reference number as the element, followed by the letter B.

The actuators and sensors do not appear in FIG. 1. These are only shown diagrammatically in FIG. 2. The installation of the sensors and actuators in the operating table is within the reach of the skilled person. .

Each actuator can be controlled from two specific keys provided on a table control member 18, shown alone on a larger scale in FIG. 3.

On this control member, two control buttons are provided for controlling each actuator in two opposite directions. For each actuator, the two buttons associated with opposite directions are designated by the same reference number as the element of the table ordered, followed by the letters C and D.

The column 14 is movable relative to the base 12 in order to allow the height of the patient support plate 16 to be adjusted. To this end, it comprises an actuator 14A disposed between the base 12 and the plate 16. This actuator is associated with a position sensor 14B. The actuator is controlled from the keys 14C and 14D of the control member 18. The assembly of the plate 16 is mounted so that it can slide with respect to the column 14 in a direction transverse to the axis of the pillar. To this end, means for guiding and motorizing the plate relative to the top of the pillar are provided. These are shown on a larger scale in Figure 4. They comprise, on each side of the plate 16, a first lower rail

20, substantially horizontal, fixed to an upper end of the column 14 by two crosspieces 22. They also include a second substantially horizontal upper rail 24 disposed above the lower rail 12 and parallel to this one. The upper rail 24 is integral with a spar 26 of the plate and is movable in translation with the latter relative to the first fixed lower rail 20.

For each of the two pairs of rails 20, 24, a carriage 28 is mounted to slide horizontally freely on the fixed lower rail 20, from one end to the other of the latter. The upper rail 24 is mounted on the carriage 28 and can slide horizontally relative to the latter.

The operating table 10 is provided with an actuator denoted 16A for translational drive of the whole of the plate 16 relative to the column 14. This actuator ensures the translational movement of each upper rail 24 relative to the lower rail fixed 20 associated.

In the envisaged embodiment, the actuator 16A is rotary. Its body is secured to one end of the fixed lower rail 20. Its output pinion is connected by a chain to a pinion of a rotary shaft disposed in the middle part of the rail 20. This shaft extends perpendicular to the rails 20 and 24 At its other end, the rotary shaft comprises a pinion meshing with a rack extending along the entire length of the rail 24, the rack being carried by the inner face of the rail 24.

With an arrangement as described below, the upper rail 24 can be moved from one end to the other of the lower rail 20 and can, in its extreme positions, extend in overhang beyond the lower rail 20, thus allowing a very large amplitude of movement of the plate 16.

The actuator 16A is equipped with a position sensor 16B and is controlled from two keys 16C and 16D of the control member allowing, respectively, the movement of the plate towards the head of the patient (advance), and towards the feet of it (recoil), when a patient is lying on the table.

The plate 16 comprises, in its middle part, a seat 30 carried by the side members 26. An actuator 30A is disposed between the seat and the top of the column 14 in order to allow the tilting of the plate 16 to be controlled relative to the axis of the column and this around an axis generally extending transversely to the longitudinal axis of the plate 16. The actuator 30A is associated with a position sensor 30B and is controlled by two buttons 30C and 30D of the control member 18, these buttons respectively corresponding to a tilting of the patient head down (tilt) or, on the contrary, lift the patient head up (proclive).

A backrest 32 is articulated at one end of the seat 30. An actuator 32A is arranged between the backrest and the seat to allow angular displacement of the seat soϋs the control of two buttons 32C and 32D of the control member , these being respectively associated with an ascent and a descent of the seat.

A position sensor 32B is also associated with the actuator 32A in order to determine the position of the backrest relative to the seat.

The free end of the backrest is extended by a removable headrest 33. The seat 30 has, at its end, in the region of connection to the backrest 32, a movable support or block 34 movable between a retracted position in the general plane of the seat 30 and a deployed position, in which it projects relative to the general plane of the seat 30.

The block 34 is intended to act on the patient's kidneys to push them away from the backrest 32.

The block 34 is controlled by an actuator 34A disposed between this support and the seat 30. This actuator is controlled from two buttons 34C and 34D of the control member respectively allowing the deployment or retraction of the block 34. The actuator is associated with a position sensor 34B.

A leg 36 is articulated at the other end of the seat 30. It is controlled by an actuator 36A disposed between the leg 36 and the seat 30. This actuator is associated with a position sensor 36B. It can be moved under the control of the keys 36C and 36D of the control member, these keys being associated respectively with the raising and lowering of the leggings.

Finally, a last actuator is interposed between the plate 16 and the upper end of the column 14 in order to allow lateral tilting to the right and to the left of the seat and therefore of the plate 16 around its longitudinal axis. The actuator 38A thus allows an inclination of the entire plate. This actuator is noted 38A and does not respect the notation convention, since it constitutes a second actuator acting on the plate 16. While the actuator 30A ensures a tilting of the seat and of the whole of the plate 16 around d 'A transverse axis of the plate, the actuator 38A ensures a lateral inclination of the seat and of the whole plate around an axis longitudinal to the plate. The actuator 38A is associated with a position sensor 38B and is controlled by two keys 38C and 38D of the control member 18 ensuring a lateral tilt, respectively, to the left and to the right.

The table control circuit is illustrated diagrammatically in FIG. 2. It comprises a central information processing unit 50 to which the control member 18 is connected, by a bidirectional information transfer link.

In addition, the central information processing unit 50 is connected to a control interface 52 to which each of the actuators 14A, 16A, 30A, 32A, 34A, 36A and 38A is connected. The control interface 52 is adapted to supply supply currents to the actuators as a function of control information received from the central information processing unit. In particular, the control interface is adapted to control, in one direction or the other, each of the actuators as a function of the information received from the central unit 50 and this for a period corresponding to the desired travel stroke for the element controlled by the corresponding actuator.

Likewise, the central information processing unit 50 is connected to a read interface 54 to which each of the sensors 14B, 16B, 30B, 32B, 34B, 36B and 38B associated with the actuators is connected. This read interface is adapted to continuously receive current position values from each of the elements of the operating table and to address these to the central information processing unit 50.

The central information processing unit 50 is also connected to means 56 for storing a set of programs and routines implemented for the operation of the table as well as means 58 for storing a set of data relating to the structure of the table and to specific control laws thereof.

In addition, the central information processing unit 50 includes means 59 for storing messages of operating faults produced during the operation of the operating table.

The control member 18, shown on a larger scale in FIG. 3, comprises, in addition to the control buttons described above, a set of control buttons making it possible to lock the operation of the table or even to stop of the food of this one.

Each of the control buttons is advantageously backlit to facilitate its identification and the manipulation of the control member. In its upper part, the control member 18 comprises a display screen 60 on which there is a schematic representation of the table, each of the movable elements of the table being associated with its own display on which a representative value is permanently displayed. of the position of the element considered. The display screen 60 is advantageously backlit for better readability.

In addition, the control member comprises, according to the invention, means 62 making it possible to make available to the user a corrective order to clean up a situation where there is a risk of collision of an element during '' a particular command applied to the operating table.

The means 62 for making the corrective order available include, for example, a display allowing the display of a line of text, on which is specified, in particular, the element to be moved, and the direction of movement of the element, in order to put an end to the potential collision situation.

In addition, the control member 18 includes an alarm 64 such as an indicator light and / or a sound emission transducer allowing to draw the attention of the user when a risk of collision occurs and the running travel request is stopped.

The information displayed on the display device 60, and in particular on the display 62, comes from the central information processing unit 50. The values presented on the individual displays associated with each mobile element of the table are addressed by the central information processing unit 50 collecting this information from the read interface 54 to which each of the sensors is connected.

The message reproduced on the display 62 is sent by the central information processing unit 50 during the implementation of the routine, the algorithm of which is illustrated in FIG. 5.

At rest, the central information processing unit 50 waits, in step 70, for the reception of a movement request. For this, it scans all the keys of the control member 18. As long as no key is pressed, step 70 is implemented continuously.

As soon as one of the keys is pressed, the routine checks, in step 72, whether the requested movement is possible without there being a risk of collision for a mobile element of the table. For this purpose, the position of the element whose displacement is requested is compared with a limit value. According to a first embodiment of the invention, the limit values, for each actuator, are stored in the storage means 58.

According to a second embodiment of the invention, the limit values, for each actuator, are calculated as a function of the positions of the other mobile elements of the seat. The limit values are calculated on the basis of laws stored in the storage means 58. Examples of such laws are given in the following description. These laws are adapted to make it possible to determine whether the movement requested by the user is possible without resulting in a collision either between two elements of the table, or between an element of the table and an surrounding obstacle such as the ground.

Such a law can take the form of an inequality which must be verified by the current position value of the mobile element considered, this inequality depending on parameters formed by the current position values of the other moving elements.

If, in step 72, the displacement is not possible, the measured position value not meeting the criteria making the displacement possible, the indicator light 64 is lit, in step 73, to warn the user that the requested move cannot be performed. No actuator control is therefore performed.

Step 74 is then implemented during which the central information processing unit 50 determines a corrective order for ordering another element of the table, in order to allow, after displacement of this other element of the table, that the movement initially requested by the user can be implemented without risk of collision.

This corrective order of order is collected in the storage means 58 according to the initial displacement request formulated by the user.

Examples of such corrective order orders are given in the following description. The purpose of these corrective order orders is to put an end to the risk of collision during the implementation of the initial movement requested by the user. Thus, these corrective control orders are intended to modify the configuration of the table in order to put an end to the impossibility resulting from the non-satisfaction of the criterion during the test carried out in step 72.

The corrective movement order determined in step 74 is made available to the user, in step 76, by display on the display 62. The corrective order made available to the user comprises a identification of the actuator to be put into action or of the element of the table to be moved, as well as an identification of its direction of movement.

In other words, the message provided on the display 62 allows the user to determine the key of the control member 18 that he must press to stop the risk of collision detected in the event of movement of the table, in accordance with his initial travel request. At the end of step 76, the test carried out in step 70 is again implemented in order to allow the user to make another request to move the table from the control member. 18.

In particular, the user is encouraged to take account of the corrective order of command displayed on the display 62 and to implement it by pressing the corresponding key in order to move the designated element and this in the direction given in corrective order.

After implementation of the corrective order, the movement initially requested by the user can be executed. If, in step 72, the requested movement is deemed possible by the information processing unit 50, the corresponding actuator is controlled, in step 78, from the interface 52. During the movement of the actuator, the test carried out in step 80 is implemented in a loop in order to check whether movement is still possible without risk of collision for the various elements of the table.

As soon as a risk of collision is detected, the actuator is stopped in step 82 and steps 73 to 76 are again implemented. In particular, a corrective order of command is displayed on the display 62 in order to provide the user with an indication of a new request for movement of the table which, after implementation, must allow the initial request for movements to be able to to be prosecuted.

As long as movement is possible, the test carried out in step 84 checks whether the movement request is still valid, namely whether the user always presses the button corresponding to the control of an actuator. As long as the request is still valid, steps 80 and 84 are implemented in a loop.

As soon as the movement request is no longer valid, that is to say that the user releases the control plug which he kept pressed, the actuator is stopped in step 86, after what the test performed in step 70 is again implemented in a loop until a new request to move the table.

It is understood that with the implementation of such a routine, the user is no longer clueless when, during a travel request by pressing a key, no movement of the table occurs, or this movement is only temporary and is interrupted when the user has not released the corresponding control key.

In fact, when such a stop of the actuator or a refusal to trigger the actuator occurs, due to the detection of a risk of collision of an element of the table, the user is immediately affected. informed by an alarm and a corrective order command is made available to it by display on the display 62, Det corrective order being such that if it is implemented, the travel request initially requested may be implemented.

In the table which follows are given examples of corrective order orders with the indication of travel requests made impossible and the indication of the message made available to the user.

In the table below, the first column indicates the command for which a risk of collision may occur. The number of the button of the control member 18 ensuring this movement is recalled in brackets.

The second column indicates the figure on which the operating table is illustrated in a position where a collision can occur during the implementation of the command indicated in the first column.

The third column recalls the elements that can collide with each other.

The fourth, fifth and sixth columns each detail an elementary condition capable of causing a collision, these conditions relating to the current position values of each of the actuators supplied by the sensors placed on the operating table.

Depending on the case, when the two or three conditions are satisfied, then the shutdown of the actuator in motion is triggered and a message appears on the display to indicate to the user a corrective command order which can be activated. artwork.

Thus, the movement space of the operating table is divided into distinct situations by conditions. The seventh column gives the corrective order of order made available to the user by its display on the display 62. It is indicated, in brackets, the button of the control member which must be pressed for this order order fix applied. The eighth column indicates the malfunction message recorded in the storage means 59 when a risk of collision or a collision is detected.

In the following table, the following variables are used. h = displacement in height of the column, t = translation of the plate, d ° = angle of the leg, b ° = angle of the backrest, l ° = angle of lateral inclination, k = height of the block. F1 to F6 are geometric and arithmetic functions dependent on the kinematics of the operating table.

C1 to C6 are constants characteristic of the geometry of the operating table and serve as the basis for the comparisons.

G- M O in O in n

In the first case illustrated in FIG. 6A, the plate 16 of the table is largely offset towards the feet of the patient. In this case, the descent of the backrest 32, by pressing the button 32D, is limited or prohibited, due to the risk for the rear face of the backrest 32 to strike the end of the rail 20, as indicated by the arrow F6A on this Fig.

When stopping the descent of the backrest, as soon as the conditions indicated in the sixteenth line of the table are satisfied, the corrective order of command "movement of the tray towards the head" is displayed on the display 62. This order prompts the user of the table to move the tray by pressing the key 16C, in order to move the backrest from the rail 20, and thus subsequently allow a greater descent of the backrest.

In the following case also illustrated in FIG. 6A, it is assumed that the tray is not completely moved towards the feet and that the backrest is already largely folded down. The command to move the plate towards the feet gives rise to a risk of striking the end of the rail 20 by the backrest 32. The movement of the plate towards the feet is interrupted as soon as the conditions indicated in the seventh line of the table are satisfied . When refusing to satisfy the user's movement request aiming to move the platform further towards the feet, the message "file lift" appears on the display 62.

In the case where the plate 16 is widely moved towards the patient's head, as illustrated in FIG. 6B, the request for movement aiming to lower the leggings 36 is only satisfied until the conditions indicated in the twelfth line of the table are checked. Indeed, and as indicated by arrow F6B, a risk of collision between the leg 36 and the lower rail 20 exists. As soon as this condition is verified, the downward movement of the leggear 36 is prohibited or interrupted and the message "movement of the platform towards the feet" appears on the display 62.

Similarly, when the leg 36, as illustrated in FIG. 6B, is largely lowered, the request to move the plate 16 aiming to move the latter towards the head is prohibited or interrupted as soon as the conditions indicated in the fourth line of the table are satisfied. Indeed, a risk of collision between the leg 36 and the lower rail 20 exists. During stopping the movement of the plate 16, the message "leg lift" is displayed.

When the plate 16 is largely tilted on the side of the patient's head, as illustrated in FIG. 6C, the request to lower the backrest 32 is prohibited or interrupted, to prevent its end equipped with the headrest 33 from hitting the ground , as indicated by arrow F6C. As soon as the conditions indicated in the fifteenth row of the table are satisfied, the movement down of the backrest 32 is prohibited and the message "tilting table side feet" is displayed. Other possible collision conditions between the headrest and the ground, as illustrated in FIG. 6C, are set out in table 1, in lines 3, 18 and 25.

As illustrated in FIG. 6D, when the plate 16 is widely inclined towards the feet, the downward tilting of the leggear 36 is prohibited as soon as the conditions indicated in the eleventh line of the table are verified and the message "lifting column " is posted. Indeed, there is a risk that the end of the leg 36 will strike the ground, as indicated by the arrow F6D.

In the same situation illustrated in FIG. 6D, when the leggear 36 is folded down considerably, the inclination further from the platform towards the feet (proclive) is prohibited to avoid a shock of the leggear against the ground, as indicated by arrow F6D. This prohibition is implemented as soon as the conditions indicated in the nineteenth row of the table are verified and the message "column lift" is displayed. Cases of possible collisions as illustrated in FIG. 6D are explained in the second, ninth and twenty-second lines of the table. For each case, the message displayed is given in the seventh column.

When the leg 36 is folded down, as illustrated in FIG. 6E, the request to reduce the height of the column 14 is prohibited as soon as the conditions indicated in the first column of the table are satisfied and the message "lifting leggings "is displayed. Indeed, there is a risk of shock, as illustrated by arrow F6E, of seeing the end of the leg strike the ground. Likewise, in this same situation illustrated in FIG. 6E, when the plate 16 of the table is already at a relatively low level, the downward movement of the leggear 36 is limited as soon as the conditions indicated in the tenth column of the table are checked in order to prevent ^'the former Tremite the leg from hitting the ground. When the request to move the leg cannot be satisfied, the message "raising the column" is displayed.

Other cases of potential collisions and messages then displayed on the screen in a case corresponding to that of FIG. 6E are explained in the table in the fifth, eighth, twentieth and twenty-third lines. As illustrated in FIG. 6F, when the leg 36 is largely folded down, there is a risk of it striking the column 14, as indicated by the arrow F6F.

Thus, as envisaged in the sixth line of the table, when a request is made to translate the plate towards the head, the command is interrupted as soon as the conditions indicated in the sixth line are verified. The message "leg lift" is then displayed.

Other conditions of potential collisions between the end of the leg and the column are explained in the thirteenth, twenty-first and twenty-fourth lines of the table.

Finally, and as illustrated in FIG. 6G, when the block 34 protrudes relative to the seat 30, the “backrest up” command must be limited in order to avoid a shock between the backrest and the block, as indicated by the arrow F6G. Thus, as indicated in the fourteenth line of the table, when the conditions indicated in this line are satisfied, the rise of the backrest is interrupted and the message "log lowering" is displayed.

Of course, the cases of potential collision and the solutions provided appearing in the table above are only examples and the other cases of collision are also treated by implementing the routine exposed in FIG. 5. Furthermore, the central information processing unit 50 is adapted to determine the collision of any mobile element of the table during its movement with an object placed on the path of the mobile element.

To this end, during each movement of a mobile element of the table, the central information processing unit tracks the evolution of the value provided by the sensor associated with the actuator acting on the mobile element. If an object placed in the path of the movable element causes the actuator to stop, even momentarily the central information processing unit detects this stop due to the non-temporal evolution of the value supplied by the associated sensor to the actuator. The actuator control is immediately interrupted and an "abnormal stop" message is sent to the user by display on the display 62.

The user thus informed can then check whether an object effectively hinders the movement of the mobile element.

Claims

CLAIMS 1.- Operating table (10) comprising at least three mobile elements (12, 14, 16, 30, 32, 34, 36) relative to each other, and at least two actuators (14A, 16A, 30A , 32A, 34A, 36A, 38A) each controlling the movement of two elements with respect to each other, the table further comprising means (50, 52) for controlling each actuator and means (14B, 16B , 30B, 32B, 34B, 36B, 38B, 50, 54) for detecting a risk of collision of a movable element of the operating table with an obstacle during the execution of a request for movement of a first actuator, characterized in that it comprises means (50) for determining a corrective order for controlling a second actuator different from the first actuator, upon detection of a risk of collision, the execution of the correct command order by the second actuator to stop the detected risk of collision, during a subsequent execution of the dep lace-up of the first actuator, and means (62) of providing the user with this corrective order of command.

2.- Table according to claim 1, characterized in that said means for making the corrective order available include means (62) for displaying the actuator to be controlled, and for the direction of control of the actuator.

3.- Table according to claim 1 or 2, characterized in that it comprises means (50, 52) for stopping the first actuator when detecting a risk of collision of the movable element of the table d with an obstacle.

4.- Table according to any one of the preceding claims, characterized in that said means for detecting a risk of collision of a mobile element of the operating table with an obstacle comprises means (14B, 16B, 30B , 32B, 34B, 36B, 38B) for determining values of the current position of the movable elements of the table.

5.- Table according to claim 4, characterized in that said detection means comprise means (50) for comparing the values of the current position of the elements of the table with, predetermined limit values.

6.- Table according to claim 5, characterized in that said detection means comprise means (58) for storing predetermined limit values.

7.- Table according to claim 5, characterized in that said detection means comprise means for calculating predetermined limit values as a function of the values of the current position of the other elements of the table.

8.- Table according to any one of the preceding claims, characterized in that it comprises means (50) for detecting an involuntary stop of a moving element in movement.